What is the Advantage/Disadvantage of Getting the Focal Point Set For Intermediate-Monofocal IOL

Posted , 3 users are following.

Since intermediate covers about 20 to 40 inches why would anyone get their focal point set there? My doctor had recommended to me in a brief discussion that it might be the right one since I have macular degeneration. Would like to hear, however, of anyone's experience with monofocals set to intermediate. It would seem a small focal point when you could get a larger range with distance and some stronger advantages with near if you use computers extensively.

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  • Edited

    Spring

    You have gotten a lot of good advice about your IOL selection, especially from Ron. What makes you particularly unique is that you have intermediate AMD and your cataract surgeon has advised you to have your IOL set for intermediate vision. What you need to do is to find out from her EXACTLY WHY she thinks that is necessary. I couldn't find anything on the Internet about AMD and where the refractive distance on the IOL is set. But maybe she has a reason. I would print out what Ron said about mini-monovision and contrast and show it to her. Mini-monovision does work for most but not all people. Let the forum know what her reason is. I am rather curious, myself. And, of course, you can always get a second opinion. An ophthalmologist who is a Cornea/Anterior Segment specialist has an extra year of training in cornea diseases and is a specialist in cataract surgery. Consult with one of them if you can. Also, if you have AMD, I assume you are seeing a Retina and Vitreous specialist. Are you? If so, I would ask that person if where the IOL is set makes a significant difference. I know doctors are in a hurry, but be assertive and make sure you get a clear answers to your questions.

    From what I have read, when someone like you with significant AMD has cataract surgery, how much your vision will be improved is more difficult to predict than with someone with no AMD. The experiences of other people with intermediate vision may not apply to you. And remember that the refractive outcome of cataract surgery can vary from person to person. I wish you well.

    • Posted

      .Thank you very much for all the detailed information which I wrote down. I want now to slow this down and visit some of these specialists which I have not seen. I am with an HMO and now even thinking of changing health plans as I want to be very careful about this surgery. I am reading a good book which is the first of many that I will read titled, "The Eyes Have It" by Susan Ryan where she as a patient offers excellent information about her experience. She had success with her operation but her mother came out of it with a damaged retina and had problems for years. Susan as a result has seen both sides of the coin and seems very wise. When I speak with my doctor on Tuesday I will certainly ask her what her reason is for recommending intermediate and post it when I find out.

  • Edited

    I thought I answered this one before, but perhaps forgot to post it. I would ask her to explain the reason for intermediate. I would also be more specific about the distance. Distance, Intermediate, and Close can mean different things to different people. The target diopter is a closer measure of what you would be getting. Some examples of the diopter peak vision target distances. The diopter target is what they plug into the IOLMaster computer program to determine what lens power to use.

    .

    1. -1.00 D = 40"
    2. -1.25 D = 32"
    3. -1.50 D = 27"
    4. -1.75 D = 23"
    5. -2.0 D = 20"

      .

      And so on. Just divide 40" by the diopter target to get the distance. And remember this is just the peak vision point. There is useable vision on each side of the peak.

    • Posted

      I haven't understood this but it looks like if my monofocal is 1 D I would see 40 inches as the sharpest vision? If there is useable vision on either side of it? How much would there be?

    • Posted

      Looking at the defocus curves I would estimate a monofocal set to -1.0 D would peak as you say at 40" (20/20+), but should be useable (20/32 vision) from 12 feet down to 20". I think if you want good computer monitor vision then setting it to -1.5 D might be a little better. Peak vision would be at 27". The good vision cut offs would shift to 53" down to 16". This is about what I have in my near eye and I can see a little closer than that. It does vary from individual to individual. The defocus curves are just an average.

    • Posted

      Oh, I finally get it now! That explanation makes sense. It is where you set the diopter as to what the range will be! Thanks for that valuable info!

  • Posted

    How did you set your distance eye?

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